Provider Demographics
NPI:1417615592
Name:FRAMINGHAM CHIROPRACTOR INC
Entity Type:Organization
Organization Name:FRAMINGHAM CHIROPRACTOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-879-9458
Mailing Address - Street 1:657 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2960
Mailing Address - Country:US
Mailing Address - Phone:508-879-9458
Mailing Address - Fax:508-879-4053
Practice Address - Street 1:657 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2960
Practice Address - Country:US
Practice Address - Phone:508-879-9458
Practice Address - Fax:508-879-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty